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Background: Optimal patient recovery from open-heart surgery relies on effective discharge planning and education. However, the nature of the discharge experience has not been clearly described. Objective: The study purpose is to explore patients' and nurses' narrative accounts of the facilitators and barriers of heart surgery discharge. Methods: A qualitative study was employed using a narrative methodology that elicited and analyzed stories. This research was conducted in a large, urban hospital in Ontario, Canada. A total of 17 patients and nurses were recruited. Five female and 5 male patients were recruited from a preoperative clinic. Ages ranged from 37 to 80 years. Seven nurses were recruited from inpatient cardiovascular units. They had 2 to 19 years of cardiovascular nursing experience. Semistructured, narrative-based interviews were conducted. Two interviews were conducted with each patient at 1 week after discharge and at 4 to 6 weeks. One interview was conducted with each nurse. Results: Findings indicate that although the preoperative period was identified as an effective time for discharge preparation, the patient's cognitive capacity was limited during the postoperative phase of surgery. Both nurses and patients also found that insufficient time impeded the discharge process and limited individualized discussions. The structured and standardized delivery of discharge information affected patients' capacity to apply it to the particularities in their own lives and homes. The fostering of therapeutic relationships created a space where patients felt comfortable sharing their concerns and nurses learned more about patients and thus could better tailor the discharge approach. Conclusions: Study recommendations include group and scenario-based education in which patients and nurses brainstorm about how to apply the discharge information to the particularities of patients' lives and homes. Provision of support needs to be bolstered during the home period, where patients have timely opportunities to discuss their concerns and questions with practitioners or possibly peers. [ABSTRACT FROM AUTHOR]

Over a quarter of all heart surgery patients are readmitted to hospitals across Canada with post-operative complications experienced during the first three months of recovery. This may be due to the quality of existing patient education intervention. Specifically, the mode, episode, and timing of delivery of standard education programs may not be optimal in promoting self-care behaviours, resulting in the development of complications and leading to increased hospital readmissions. The objectives of this preliminary descriptive study were twofold: (1) to describe the most consistent mode, episode, and timing in which education is provided to patients following heart surgery and (2) to identify the degree to which the current educational mode and episode are correlated to readmission rates following hospital discharge. A non-experimental preliminary descriptive design was used to address the study objectives. Setting: Thirty-three patients were recruited from a cardiovascular surgical unit located within a large tertiary hospital. Method: Patients were included if they underwent heart surgery for the first time, were literate in English, cognitively oriented, and had access to a working phone at home. Point-biserial correlations were performed to identify the degree to which the characteristics of existing patient education were correlated to hospital readmission rates. Results: A statistically significant inverse relationship between episode and hospital readmission (rpb = (0.49, p = 0.001) was noted, suggesting that with reduced exposure to patient education, there is an increased likelihood for hospital readmissions. Conclusion: Increasing the number of times education is provided may reduce the number of hospital readmissions. [ABSTRACT FROM AUTHOR]